Abstract:
Purpose To better understand the long-term hand and shoulder outcomes of upper brachial plexus birth injuries. Methods We evaluated shoulder and hand function in 32 patients (13 males; 19 females) with a C5/C6 birth injury history). All patients had undergone primary nerve surgery as infants, and 12 underwent a simultaneous shoulder procedure as they presented with a fixed internal rotation contracture of the shoulder. On average, all patients were evaluated and examined 15 years postoperatively. The shoulder function was evaluated using the Miami Shoulder Scale. Hand function was measured by the 9-hole peg test (9-HPT) and statistical analysis included comparison of 9-HPT time against normative data using the Student\'s t -test. Results The cohort includes 22 right-hand-dominant and 10 left-hand-dominant patients. Mean age at surgery was 10 months; mean age at follow-up was 15 years ± 2 years 2 months. Cumulative shoulder function was \"good\" or \"excellent\" (Miami score) in 23 patients. For 9-HPT, 23 out of 32 patients seen had an involved hand with a significant alteration in function. Conclusion Early nerve surgery in cases of upper brachial plexus birth injuries result in the desired outcome. To ensure timely and targeted therapy for any residual deficits, it is imperative that limitations in hand function among children with an Erb\'s palsy.
摘要:
目的更好地了解臂丛神经上损伤的手和肩的长期结局。方法我们评估了32例有C5/C6出生损伤史的患者(男性13例;女性19例)的肩和手功能。所有患者在婴儿时期都接受过原发性神经手术,12名患者同时接受了肩部手术,因为他们表现出肩部的固定内旋挛缩。平均而言,所有患者在术后15年接受评估和检查.使用迈阿密肩量表评估肩功能。通过9孔钉试验(9-HPT)测量手功能,统计分析包括使用Studentt检验将9-HPT时间与标准数据进行比较。结果该队列包括22例右手优势患者和10例左手优势患者。手术时的平均年龄为10个月;随访时的平均年龄为15岁±2岁2个月。23例患者的累积肩关节功能为“良好”或“优秀”(迈阿密评分)。对于9-HPT,在32例患者中,有23例受累的手的功能发生了显着改变。结论早期手术治疗上臂丛神经损伤可达到理想的效果。为了确保对任何残留缺陷进行及时和有针对性的治疗,必须限制Erb麻痹儿童的手功能。